Table 3.
Reported healthcare and PT visits by study
| Author, year | Healthcare visits | PT visits / duration |
|---|---|---|
| Low back pain | ||
| Childs, 2015 [22] |
Mean PT visits: Adherent 6.2 (SD 7.6) Nonadherent 15.0 (SD 17.2) Early 7.3 (SD 12.9) Delayed 6.8 (11.0) |
|
| Fritz, 2012 [16] |
PT utilization: 7.0% in first 90 days Visits: mean 6.4 (SD 5.1), 14.2% received only one visit 53.1% received early physical therapy, 46.9% received delayed Median time to PT: 14 days (IQR 6–33) Predictors of PT Utilization: higher index visit copayment; aOR =1.02; P= 0.022 not receiving long-term disability: aOR = 0.21; P=.04 greater number of diagnosis codes at index visit: aOR =1.04; P<.001 not having comorbid neck/ thoracic pain: aOR = .76; P<.001 Midwest as the reference, utilization in: Northeast, aOR = 1.59; P<.001 West aOR =1.61, P<.001 not living in the South: aOR = 0.82; P=.004 Early PT: LBP-related costs were $2736.23 lower (95% CI 1810.67 to 3661.78) decreased likelihood of advanced imaging: OR = 0.34, (95% CI 0.29 to 0.41) additional physician visits: OR = 0.26, (95% CI 0.21 to 0.32) |
|
| Hoeijenbos, 2005 [25] |
General practitioner utilization. all: Baseline 94% 6 weeks 25% 12 weeks 10% 4 patients were hospitalized during the 1-year follow-up for an average of 1.5 days Utilization in 6 weeks GP Contact: Baseline: Intervention 93.8%, mean 1.4, median 1; Control 94.6%, mean 1.6, median 1 6 weeks: Intervention 23.6%, mean 0.42, median 0.0; Control: 25.7%, mean 0.45, median 0.0 12 weeks: Intervention 7.2%, mean 0.13, median 0.0; Control: 14.5%, mean 0.32, median 0.0 26 weeks: Intervention 10.2%, mean 0.17, median 0.0; Control: 11.5%, mean 0.27, median 0.0 52 weeks: Intervention 7.5%, mean 0.13, median 0.0; Control: 5.6%, mean 0.085, median 0.0 Hospitalization: Baseline: Intervention 0.0% Control 0.0% 6 weeks: Intervention 0.0% Control 0.0% 12 weeks: Intervention 0.5% control 0.5% 26 weeks: Intervention 0.5%, Control 0.0% 52 weeks: Intervention 0.0% Control 0.5% Bolded denoted significant difference from previous measure |
Utilization in 6 weeks: Physiotherapist Contact: Baseline: Intervention 89.5%, mean 2.0, median 1; Control 86.3%, mean 2.1, median 2.0 6 weeks: Intervention 75.3%, mean 4.17, median 4; Control: 80.7%, mean 5.43, median 5.0 12 weeks: Intervention 40.8%, mean 2.01, median 0.0; Control: 48.2%, mean 2.74, median 0.0 26 weeks: Intervention 11.2%, mean 0.62, median 0.0; Control: 16.2%, mean 0.90, median 0.0 52 weeks: Intervention 7.5%, mean 0.42, median 0.0; Control: 8.0%, mean 0.42, median 0.0 Physical Therapist Contact: Baseline: Intervention 2.9%, mean 0.1, median 0.0; Control 2.1%, mean 0.058, median 0.0 6 weeks: Intervention 3.0%, mean 0.1, median 0.0; Control 3.1%, mean 0.16, median 0.0 12 weeks: Intervention 3.6%, mean 0.14, median 0.0; Control 0.5%, mean 0.09, median 0.0 26 weeks: Intervention 1.4%, mean 0.12, median 0.0; Control 1.4%, mean 0.07, median 0.0 52 weeks: Intervention 4.2%, mean 0.22, median 0.0; Control 4.2%, mean 0.19, median 0.0 Manual Therapist Contract: Baseline: Intervention 20.9%, mean 0.52, median 0.0; Control 12.4%, mean 0.27, median 0.0 6 weeks: Intervention 15.3%, mean 0.67, median 0.0; Control 9.2%, mean 0.41, median 0.0 12 weeks: Intervention 7.6%, mean 0.25, median 0.0; Control 6.3%, mean 0.18, median0.0 26 weeks: Intervention 2.8%, mean 0.11, median 0.0; Control: 1.8%, mean 0.07, median 0.0 52 weeks: Intervention 3.7%, mean 0.08, median 0.0; Control: 4.2%, mean 0.073, median 0.0 Bolded denoted significant difference from previous measure |
| Karlen, 2015 [36] |
Mean number of visits: 2010: Adherent 5.1; Nonadherent 6.2 2011: Adherent 5.3; Nonadherent 6.4 2012: Adherent4.9; Nonadherent 5.7 2013: Adherent 4.8; Nonadherent 5.8 2014: Adherent 4.5; Nonadherent 5.7 Overall mean number of visits: 2010: 6.7 visits 2014: 5.4 visits |
|
| Magel, 2018 [34] |
Spine surgeon visit: All patients 25 (6.3%) Participants 3 (2.4%) Nonparticipants 22 (8.0%) Refused 8 (7.9%) Not offered 14 (8.0%) Attended physiatry within 6 months of index visit: Al Patients 327 (81.8%) Participants (41.1%) Nonparticipants 276 (100%) Refused 101 (100%) Not offered 175 (100%) Participants were less likely to have visits to spinal surgeon over the 6 month follow period compared to Nonparticipants (P< .05) |
Days to schedule initial PT visit (median days, IQR): PT via RapidAccess 2 (1, 5) PT following physiatrist visit 36 (12.5, 77.5) Mean number of PT visits: PT via Rapid Access 4.3 (SD 3.6) PT following physiatrist visit 4.8 (SD 4.4) PT via RapidAccess 25 (20.2%) attended 1 visit PT following physiatrist visit 18 (18.8%) attended 1 visit Mean duration of PT care: PT via Rapid Access 42 (SD 15; days 92) PT following physiatrist visit 49 (SD 24; days 102) P= .045 |
| Rutten, 2010 [35] |
Mean number of treatment sessions 6.7 (SD = 3.2) Association between % guideline adherence and number of sessions: B = −0.09, Beta= −0.27, P= .005 Association between % guideline adherence for individual steps and number of sessions: Treatment plan: Beta = −0.02 P= .05 Evaluation: Beta= −0.03 P= .01 Treatment: beta= −0.03 P= .00 Correlation of % Adherence and Difference in Scores for No. of Sessions: Acute LBP (<6 weeks) −0.30, P< .05 Subacute LBP (6–12 weeks) −0.28 Chronic LBP (>12 weeks) −0.37, P< .05 |
|
| Sharma, 2019 [26] |
Regular physiotherapy at the center: Pain Education 4 (21%) Control 5 (26%) P = 0.719 |
|
| Schroder, 2021 [23] |
Number of PT treatment sessions Intervention 4.6 (SD 3.8) Control 3.1 (SD 2.7) Duration PT intervention period: Intervention 63 (SD 61) Control 59 (SD 84) |
|
| Swinkels, 2005 [21] |
Number of treatment sessions: Acute: median 8.0 (IQR = 4.5–12) Chronic: median 9.0 (IQR = 6–14) |
|
| Acute low back pain | ||
| Fritz, 2007 [17] |
Visits (median, range): Adherent care 5 (3–21), Nonadherent care 6 (3–35), P= .02 Duration of Episode of PT Care (median, range): Adherent 20 (10–124) Nonadherent 26 (10–250), P< .001 |
|
| Fritz, 2008 [18] |
Rate of additional healthcare utilization: Adherent 55.3%, Nonadherent 65.8%, P< 0.05 |
Visits: Adherent group 4.6 (SD 2.0), Nonadherent group 5.9 (SD 2.2); P= .02 Duration of care (days): Adherent group 25.4 (SD 16.2), Nonadherent group 29.7 (SD 20.6); P< .001 |
| Chronic low back pain | ||
| Van der Roer, 2008 [24] |
No significant difference between groups General practitioner (consultations): Protocol 1.5 (SD 2.8), 45.5% Guideline 1.4 (SD 1.9), 55.3% Outpatient visit (no.): Protocol 0.6 (SD 2.4), 16.4% Guideline 0 (SD 0), 0% Hospitalizations (days): Protocol 0.1 (SD 0.4), 5.% Guideline 0 (SD 0), 0% |
Physical Therapy (treatment sessions): Protocol 1.1 (SD = 4.1), 9.1% Guideline 2.1 (SD = 5.7) 17.0% |
| Low back pain with radicular symptoms | ||
| Fleuren, 2010 [31] |
Unnecessary Early Referrals: Pretest: All 27 (15%) First Post-test: All 19 (9%); aOR = 0.52 (95% CI 0.28 to 0.96) Fast track 7 (6%); aOR = 0.36 (95% CI 0.15 to 0.86) Standard 12 (11%); aOR = 0.69 (95% CI 0.33 to 1.45) Second Post-Test: All 25 (8%) aOR = 0.48 (95% CI 0.27 to 0.86) Fast track 11 (7%) aOR = 0.43 (95% CI 0.21 to 0.91) Standard 14 (9%); aOR = 0.52 (95% CI 0.26 to 1.04) Duration of total diagnostic procedure: Pretest: Hospital 1: 44.5(24.4) Hospital 2: 53.7(22.7) First Post-test: Hospital 1: All 37.6 (SD 23.7) Fast track 17.4 (SD 9.7)Standard 51.2 (SD 20.4) Hospital 2: All 31.7 (SD 26.3) Fast track 17.7 (SD 12.7)Standard 59.2 (SD 24.6) Second Post-test: Hospital 1: All 41.8 (SD 21.9) Fast Track 32.5 (SD 14.4) Standard: 49.5(SD 24.1) Hospital 2: All 47.5 (SD 39.4) Fast Track 24.2 (SD 12.3)Standard 79.7 (SD 41.3) Bolded indicate significant decrease in mean days compared to pretest Italicized indicate significant increase in mean days compared with pretest |
|
| Hahne, 2017 [27] |
Proportion of Patients Receiving Co-Interventions (%) of General Medical Practitioner Visits 0–10 weeks: Intervention 12/28 (43%), Control 12/26 (46%), Risk difference −3%, 95% CI −28 to 22%, Relative risk 0.9, 95% CI 0.5 to 1.7, P = .81 11–52 weeks: Intervention 4/28 (14%), Control 12/26 (46%), Risk difference −32%, 95% CI −52 to −7%, Relative risk 0.3, 95% CI 0.1 to 0.8,P= .01 Total: Intervention 12/28 (43%), Control 15/26 (58%), Risk difference −15%, 95% CI −38 to 11%), Relative risk 0.7, 95% CI 0.4 to 1.3, P = .28 Co-intervention Sessions Attended: Median (25th to 75th percentile) of General Medical Practitioner Visits 0–10 weeks: Intervention group 0.0 (0.0 to 2.0), Control group: 0.0 (0.0–2.0), P = .88 11–52 weeks: Intervention group: 0.0 (0.0 to 0.2), Control group 0.0 (0.0 to 2.8), P< .01 Total: Intervention group 0.0 (0.0 to 2.0), Control group 1.0 (0.0 to 4.0), P = .17 Proportion of Patients Receiving Co-Interventions (%) of Any Other Healthcare Intervention Apart from Medical Practitioner 0–10 weeks: Intervention 7/28 (25%), Control 15/26 (458%), Risk difference −33% (95% CI −54 to −7%), Relative risk 0.4 (95% CI 0.2 to 0.9), P= .02 11–52 weeks: Intervention 9/28 (32%), Control 15/26 (58%), Risk difference −26% (95% CI −48 to 1%), Relative risk 0.6 (95% CI 0.3 to 1.1), P = .06 Total: Intervention 10/28 (36%), Control 21/26 (81%), Risk difference −41% (95% CI −61 to −15%), Relative risk 0.5 (95% CI 0.3 to 0.8), P< .01 Co-intervention Sessions Attended: Median (25th to 75th percentile) of Any Other Healthcare Intervention Apart from Medical Practitioner 0–10 weeks: Intervention 0.0 (0.0 to 0.03), Control 1.0 (0.0–2.3), P= .01 11–52 weeks: Intervention 0.0 (0.0 to 5.0), Control 2.0 (0.0 to 10.8), P = .11 Total: Intervention 0.0 (0.0 to 2.8), Control 2.0 (1.0 to 16.6), P<.01 |
Visits: Intervention 9.4 (SD 1.6) Control 1.8 (SD 0.4) |
| Neck pain | ||
| Cote, 2019 [28] |
Number of Visits: Mean Weeks 1–3: Government guideline 3.8 (SD 2.3) Preferred-provider 2.7 (SD 1.9) Weeks 4–6: Government guideline 2.8 (SD 2.4) Preferred-provider 2.7 (SD 2.5) GP Education and Activation: mean 1.5 visits to GP in first 6 weeks (SD 0.8) GP Visits in the first 6 weeks: Government guideline 27.5% Preferred-provider 43.8% GP Education and activation 34.8% |
Physiotherapy as Co-Intervention within the first 6 weeks: Government guideline 3.8% (1.3; 10.5) Preferred-provider 6.9% (4.7; 18.5) GP education and activation 14.5% (8.1; 24.7) |
| Horn, 2016 [19] | Adherent care: attended 46% fewer visits to health care providers. adjusted mean difference = 7.26 visits; IRR = 0.54, 95% CI 0.47 to 0.62; P< .001 | Adherent care: attended 54% fewer visits for PT during an episode of care, adjusted mean difference = 3.63 visits; IRR = 0.44, 95% CI 0.36 to 0.55; P<.001 |
Bolded indicates statistical significance
PT physical therapy, SE standard error, SD standard deviation, aOR adjusted odds ratio